Creating a skincare routine for rosacea skin – Before and After! | Ask Doctor Anne

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A while ago I showed you the step by step process of how I build a skincare routine for my sister struggling with hyperpigmentation (you can find it here). After watching that video, an old friend approached me, asking me to help her build a skincare routine for her rosacea skin and kindly agreed to let me use her pictures on the blog here.

 

Building a skincare routine for rosacea skin
That didn’t completely go as planned

 

And as many of you seemed to enjoy the “real life before and afters”, and because I just did a post on skincare tips for rosacea skin and many of the problems you might encounter if you suffer from it, I figured it would be a great time to share how far we have come. (More info: Skincare for rosacea – The Do’s and Dont’s)

 

For background information, my friend is 36 years old, is a teacher and has two small children – so no time really, not really invested in skincare and was diagnosed with rosacea a few years ago.
Back when she was first diagnosed, she was put on Soolantra, which worked, but made her skin pretty dry and tight, which is why she stopped it eventually. Over time there were breakouts again, then some redness and a general irritation with tightness. She purchased some stuff from the drugstore, but that didn’t help much, and that is where we start.

 

First impressions

This is her skin, as you can see there is general redness on the cheeks and breakouts, mainly around the chin.

 

Rosacea skin before treatment
The starting point: redness around the cheeks and breakouts on the chin

If you look closer at these breakouts, you will see that there are no blackheads, only papules and whiteheads, which is the main way to distinguish rosacea breakouts from acne.
She described her skin as dry, irritated and very sensitive.

 

Close up chin rosacea skin
Close up of the chin: papules, pustules, redness, but no comedones

 

The first thing we did was take a look at her current routine:

In the mornings she used a little water to freshen up, then some Rose Water Face Mist from Garnier (150 ml for 4,95 €) and the Avene Antirougeurs Day with SPF 30 (40 ml for 18,99 €). At night it was eye makeup remover, the same Garnier Rose Water Face Mist and then the Avene Antirougeurs Calm Masque (50 ml for 18,99 €) if she could be bothered.

 

The routine she was using when we started
The routine she was using when we started

 

Now I have two main issues with this:

For someone with dry and tight skin, I think there should be a proper face cream and some extra hydration. Nothing against Avene, but if you have dry patches, you need something more occlusive, especially at night. A face masque a few times a week will not give you the desired results.

And then that Rose Water Face Mist. Here is a picture of the ingredients:

Ingredients of the Garnier Rose Water Face Mist
Ingredients of the Garnier Rose Water Face Mist

Yes, there is Glycerin as humectant, but I think that the alcohol denat. used as solvent along with the added Fragrance and Linalool aren’t really helpful for skin that is chronically inflamed.

(More info: The truth about alcohol in skincare)

 

The skincare routine we started with

Referring back to my skincare tips blog post (which you can read here), these were my main tips:

To keep things simple, we did take a look at some easily available things from DM, a German drugstore that has a very affordable skincare line called Balea Sensitive. No potential irritants in the products we chose and easy to pick up while shopping for toothpaste and diapers. Two things weren’t available there and had to be ordered online.

 

This is the routine I put her on first
This is the routine I put her on first

 

The first suggestion for her morning routine was this:

Cleanse with water if needed, apply a layer of Geek and Gorgeous Liquid Hydration Toner (110 ml for 7,50 €, full review here), followed up with a Niacinamide Serum from Balea (it contains 10% Niacinamide and 1% Zinc, which I hoped would help with the inflammation) and then a rich hydrating sunscreen, the Garnier Super UV Anti-Age SPG 50 + with Glycerin (50 ml for 9,95 €).
The toner wouldn’t have been necessary, but she liked her face mist and I figured it would be a great replacement, as it has no essential oils, fragrance or alcohol, but Panthenol to help reduce inflammation. I picked the Garnier SPF despite it containing older chemical filters because I never found a mineral sunscreen I liked, but it was a mistake, as you will see in a bit.

 

For her evening routine it was the following:

To gently remove makeup and dirt, we started with the Balea Cleansing Oil (100 ml for 2,55 €), followed by a layer if The Ordinary Azelaic Acid Suspension 10% (30 ml for 9,95 €) and then the Baleas Ultra Sensitive Night Cream (30 ml for 3,95 €), which is basically a plain moisturizer with enough occlusives to prevent water loss, but really no irritation at all.

So a simple routine with Niacinamide and Panthenol to help with inflammation and the skin barrier, Azelaic Acid to keep the rosacea calm, a gentle cleanse and a plain rich moisturizer.

 

Skincare check in after six weeks
This is how it looked at six weeks – less redness in the cheeks, but more breakouts on the chin

 

Check in after six weeks

Now I would love to tell you that ever since her skin was at its best, happy and calm, but that would be a lie. When we did our next check-in after around six weeks, that was how her skin looked: less redness, yes, but around the chin area even worse than before. The SPF hadn’t worked for her at all, had even given her eczema around the eyes, which is why she was back on her Avene Antirougeurs Day SPF 30.

Now I would have been happier with an SPF 50, but if you apply the Avene one liberally, you are still doing great in terms of protecting your skin.

When I asked her how her skin felt though, she was actually pretty happy: No more tightness, no stinging, no dry patches, so at least something had worked.

 

The adjustments we made

The next step we took, and if you take away one tip from this post, let it be this one: The next thing we did is book a consultation with a dermatologist. You see, the breakouts and irritation around her chin were most likely caused by the need to wear a face mask all day – I told you she is a teacher – and if you have rosacea and it gets worse, there is no point in experimenting.

Active rosacea flare ups need to be treated with prescription medication before they lead to permanent changes!

Her dermatologist put her back on Soolantra, which now that her skin had the supporting skincare wasn’t an issue anymore and another few weeks later, this is the current result. Much better and most importantly with her skin still feeling soft and calm rather than tight and irritated.

 

Final skin picture
The last picture, back on prescription Soolantra

 

Take home messages

Now while this doesn’t really sound like a skincare success story, I think this routine building process teaches us two very important things about skincare for rosacea skin:
First – skincare alone isn’t enough to fix a serious skin issue and you need to see a dermatologist if things don’t improve very quickly. No matter if it is acne, rosacea or eczema.
And second – while skincare isn’t the hero here solving the problems, it is an important supporting act. The skincare we picked helped her skin feel good, which in turn made it easy to keep using the prescription, and that is not to be dismissed.

 

Rosacea skincare routine with before and after pictures
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